|
SCREW HEADLESS 2.4 X 20 317-2420
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965482
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,675.06 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,051.09
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.4 X 22 317-2422
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965484
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,675.06 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,051.09
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.4 X 22 317-2422
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965484
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$957.17 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Aetna Managed Medicare |
$957.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,222.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,709.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,640.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,913.03
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,563.86
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: NAPHCARE Commercial |
$2,051.09
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,222.01
|
| Rate for Payer: Quartz Medicare Advantage |
$2,051.09
|
| Rate for Payer: The Alliance Commercial |
$1,709.24
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.4 X 24 317-2424
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965486
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$957.17 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Aetna Managed Medicare |
$957.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,222.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,709.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,640.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,913.03
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,563.86
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: NAPHCARE Commercial |
$2,051.09
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,222.01
|
| Rate for Payer: Quartz Medicare Advantage |
$2,051.09
|
| Rate for Payer: The Alliance Commercial |
$1,709.24
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.4 X 24 317-2424
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965486
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,675.06 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,051.09
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.4 X 26 317-2426
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965488
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,675.06 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,051.09
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.4 X 26 317-2426
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965488
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$957.17 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Aetna Managed Medicare |
$957.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,222.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,709.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,640.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,913.03
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,563.86
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: NAPHCARE Commercial |
$2,051.09
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,222.01
|
| Rate for Payer: Quartz Medicare Advantage |
$2,051.09
|
| Rate for Payer: The Alliance Commercial |
$1,709.24
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.4 X 28 317-2428
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965490
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,675.06 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,051.09
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.4 X 28 317-2428
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965490
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$957.17 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Aetna Managed Medicare |
$957.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,222.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,709.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,640.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,913.03
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,563.86
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: NAPHCARE Commercial |
$2,051.09
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,222.01
|
| Rate for Payer: Quartz Medicare Advantage |
$2,051.09
|
| Rate for Payer: The Alliance Commercial |
$1,709.24
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.4 X 30 317-2430
|
Facility
|
IP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965492
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,675.06 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,051.09
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 2.4 X 30 317-2430
|
Facility
|
OP
|
$3,287.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
2965492
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$957.17 |
| Max. Negotiated Rate |
$3,145.00 |
| Rate for Payer: Aetna Commercial |
$3,076.63
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,939.89
|
| Rate for Payer: Aetna Managed Medicare |
$957.17
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,222.01
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,709.24
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,640.87
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,811.79
|
| Rate for Payer: Cash Price |
$986.10
|
| Rate for Payer: Cigna Commercial |
$3,145.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,913.03
|
| Rate for Payer: Health EOS Commercial |
$3,042.45
|
| Rate for Payer: HFN Commercial |
$3,145.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,563.86
|
| Rate for Payer: Multiplan Commercial |
$2,734.78
|
| Rate for Payer: NAPHCARE Commercial |
$2,051.09
|
| Rate for Payer: Preferred Network Access Commercial |
$3,145.00
|
| Rate for Payer: Quartz Beloit One Network |
$1,675.06
|
| Rate for Payer: Quartz Commercial |
$2,222.01
|
| Rate for Payer: Quartz Medicare Advantage |
$2,051.09
|
| Rate for Payer: The Alliance Commercial |
$1,709.24
|
| Rate for Payer: WEA Trust Commercial |
$1,880.16
|
| Rate for Payer: WPS Commercial |
$2,531.98
|
|
|
SCREW HEADLESS 3.0 x 24 #AH3024
|
Facility
|
IP
|
$2,593.00
|
|
| Hospital Charge Code |
2964745
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,321.39 |
| Max. Negotiated Rate |
$2,480.98 |
| Rate for Payer: Aetna Commercial |
$2,427.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,319.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,429.26
|
| Rate for Payer: Cash Price |
$777.90
|
| Rate for Payer: Cigna Commercial |
$2,480.98
|
| Rate for Payer: Health EOS Commercial |
$2,400.08
|
| Rate for Payer: HFN Commercial |
$2,480.98
|
| Rate for Payer: Multiplan Commercial |
$2,157.38
|
| Rate for Payer: Preferred Network Access Commercial |
$2,480.98
|
| Rate for Payer: Quartz Beloit One Network |
$1,321.39
|
| Rate for Payer: Quartz Commercial |
$1,618.03
|
| Rate for Payer: WEA Trust Commercial |
$1,483.20
|
| Rate for Payer: WPS Commercial |
$1,997.39
|
|
|
SCREW HEADLESS 3.0 x 24 #AH3024
|
Facility
|
OP
|
$2,593.00
|
|
| Hospital Charge Code |
2964745
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$755.08 |
| Max. Negotiated Rate |
$2,480.98 |
| Rate for Payer: Aetna Commercial |
$2,427.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,319.18
|
| Rate for Payer: Aetna Managed Medicare |
$755.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,752.87
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,348.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,294.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,429.26
|
| Rate for Payer: Cash Price |
$777.90
|
| Rate for Payer: Cigna Commercial |
$2,480.98
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,509.13
|
| Rate for Payer: Health EOS Commercial |
$2,400.08
|
| Rate for Payer: HFN Commercial |
$2,480.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,022.54
|
| Rate for Payer: Multiplan Commercial |
$2,157.38
|
| Rate for Payer: NAPHCARE Commercial |
$1,618.03
|
| Rate for Payer: Preferred Network Access Commercial |
$2,480.98
|
| Rate for Payer: Quartz Beloit One Network |
$1,321.39
|
| Rate for Payer: Quartz Commercial |
$1,752.87
|
| Rate for Payer: Quartz Medicare Advantage |
$1,618.03
|
| Rate for Payer: The Alliance Commercial |
$1,348.36
|
| Rate for Payer: WEA Trust Commercial |
$1,483.20
|
| Rate for Payer: WPS Commercial |
$1,997.39
|
|
|
SCREW HEADLESS 3.0 x 26 #AH3026
|
Facility
|
OP
|
$2,593.00
|
|
| Hospital Charge Code |
2964746
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$755.08 |
| Max. Negotiated Rate |
$2,480.98 |
| Rate for Payer: Aetna Commercial |
$2,427.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,319.18
|
| Rate for Payer: Aetna Managed Medicare |
$755.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,752.87
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,348.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,294.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,429.26
|
| Rate for Payer: Cash Price |
$777.90
|
| Rate for Payer: Cigna Commercial |
$2,480.98
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,509.13
|
| Rate for Payer: Health EOS Commercial |
$2,400.08
|
| Rate for Payer: HFN Commercial |
$2,480.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,022.54
|
| Rate for Payer: Multiplan Commercial |
$2,157.38
|
| Rate for Payer: NAPHCARE Commercial |
$1,618.03
|
| Rate for Payer: Preferred Network Access Commercial |
$2,480.98
|
| Rate for Payer: Quartz Beloit One Network |
$1,321.39
|
| Rate for Payer: Quartz Commercial |
$1,752.87
|
| Rate for Payer: Quartz Medicare Advantage |
$1,618.03
|
| Rate for Payer: The Alliance Commercial |
$1,348.36
|
| Rate for Payer: WEA Trust Commercial |
$1,483.20
|
| Rate for Payer: WPS Commercial |
$1,997.39
|
|
|
SCREW HEADLESS 3.0 x 26 #AH3026
|
Facility
|
IP
|
$2,593.00
|
|
| Hospital Charge Code |
2964746
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,321.39 |
| Max. Negotiated Rate |
$2,480.98 |
| Rate for Payer: Aetna Commercial |
$2,427.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,319.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,429.26
|
| Rate for Payer: Cash Price |
$777.90
|
| Rate for Payer: Cigna Commercial |
$2,480.98
|
| Rate for Payer: Health EOS Commercial |
$2,400.08
|
| Rate for Payer: HFN Commercial |
$2,480.98
|
| Rate for Payer: Multiplan Commercial |
$2,157.38
|
| Rate for Payer: Preferred Network Access Commercial |
$2,480.98
|
| Rate for Payer: Quartz Beloit One Network |
$1,321.39
|
| Rate for Payer: Quartz Commercial |
$1,618.03
|
| Rate for Payer: WEA Trust Commercial |
$1,483.20
|
| Rate for Payer: WPS Commercial |
$1,997.39
|
|
|
SCREW HEADLESS 3.0 x 30
|
Facility
|
IP
|
$2,593.00
|
|
| Hospital Charge Code |
2964747
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,321.39 |
| Max. Negotiated Rate |
$2,480.98 |
| Rate for Payer: Aetna Commercial |
$2,427.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,319.18
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,429.26
|
| Rate for Payer: Cash Price |
$777.90
|
| Rate for Payer: Cigna Commercial |
$2,480.98
|
| Rate for Payer: Health EOS Commercial |
$2,400.08
|
| Rate for Payer: HFN Commercial |
$2,480.98
|
| Rate for Payer: Multiplan Commercial |
$2,157.38
|
| Rate for Payer: Preferred Network Access Commercial |
$2,480.98
|
| Rate for Payer: Quartz Beloit One Network |
$1,321.39
|
| Rate for Payer: Quartz Commercial |
$1,618.03
|
| Rate for Payer: WEA Trust Commercial |
$1,483.20
|
| Rate for Payer: WPS Commercial |
$1,997.39
|
|
|
SCREW HEADLESS 3.0 x 30
|
Facility
|
OP
|
$2,593.00
|
|
| Hospital Charge Code |
2964747
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$755.08 |
| Max. Negotiated Rate |
$2,480.98 |
| Rate for Payer: Aetna Commercial |
$2,427.05
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,319.18
|
| Rate for Payer: Aetna Managed Medicare |
$755.08
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,752.87
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,348.36
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,294.43
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,429.26
|
| Rate for Payer: Cash Price |
$777.90
|
| Rate for Payer: Cigna Commercial |
$2,480.98
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,509.13
|
| Rate for Payer: Health EOS Commercial |
$2,400.08
|
| Rate for Payer: HFN Commercial |
$2,480.98
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,022.54
|
| Rate for Payer: Multiplan Commercial |
$2,157.38
|
| Rate for Payer: NAPHCARE Commercial |
$1,618.03
|
| Rate for Payer: Preferred Network Access Commercial |
$2,480.98
|
| Rate for Payer: Quartz Beloit One Network |
$1,321.39
|
| Rate for Payer: Quartz Commercial |
$1,752.87
|
| Rate for Payer: Quartz Medicare Advantage |
$1,618.03
|
| Rate for Payer: The Alliance Commercial |
$1,348.36
|
| Rate for Payer: WEA Trust Commercial |
$1,483.20
|
| Rate for Payer: WPS Commercial |
$1,997.39
|
|
|
SCREW HEADLESS CANN 2.0 X 24 202-20-024
|
Facility
|
OP
|
$2,902.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6175006
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$845.06 |
| Max. Negotiated Rate |
$2,776.63 |
| Rate for Payer: Aetna Commercial |
$2,716.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,595.55
|
| Rate for Payer: Aetna Managed Medicare |
$845.06
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,961.75
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,509.04
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,448.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,599.58
|
| Rate for Payer: Cash Price |
$870.60
|
| Rate for Payer: Cigna Commercial |
$2,776.63
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,688.96
|
| Rate for Payer: Health EOS Commercial |
$2,686.09
|
| Rate for Payer: HFN Commercial |
$2,776.63
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$2,263.56
|
| Rate for Payer: Multiplan Commercial |
$2,414.46
|
| Rate for Payer: NAPHCARE Commercial |
$1,810.85
|
| Rate for Payer: Preferred Network Access Commercial |
$2,776.63
|
| Rate for Payer: Quartz Beloit One Network |
$1,478.86
|
| Rate for Payer: Quartz Commercial |
$1,961.75
|
| Rate for Payer: Quartz Medicare Advantage |
$1,810.85
|
| Rate for Payer: The Alliance Commercial |
$1,509.04
|
| Rate for Payer: WEA Trust Commercial |
$1,659.94
|
| Rate for Payer: WPS Commercial |
$2,235.41
|
|
|
SCREW HEADLESS CANN 2.0 X 24 202-20-024
|
Facility
|
IP
|
$2,902.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6175006
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,478.86 |
| Max. Negotiated Rate |
$2,776.63 |
| Rate for Payer: Aetna Commercial |
$2,716.27
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,595.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,599.58
|
| Rate for Payer: Cash Price |
$870.60
|
| Rate for Payer: Cigna Commercial |
$2,776.63
|
| Rate for Payer: Health EOS Commercial |
$2,686.09
|
| Rate for Payer: HFN Commercial |
$2,776.63
|
| Rate for Payer: Multiplan Commercial |
$2,414.46
|
| Rate for Payer: Preferred Network Access Commercial |
$2,776.63
|
| Rate for Payer: Quartz Beloit One Network |
$1,478.86
|
| Rate for Payer: Quartz Commercial |
$1,810.85
|
| Rate for Payer: WEA Trust Commercial |
$1,659.94
|
| Rate for Payer: WPS Commercial |
$2,235.41
|
|
|
SCREW HEADLESS COMPRESSION 4.0MM X 32MM TI 658032
|
Facility
|
IP
|
$4,236.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5729730
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,158.67 |
| Max. Negotiated Rate |
$4,053.00 |
| Rate for Payer: Aetna Commercial |
$3,964.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,788.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,334.88
|
| Rate for Payer: Cash Price |
$1,270.80
|
| Rate for Payer: Cigna Commercial |
$4,053.00
|
| Rate for Payer: Health EOS Commercial |
$3,920.84
|
| Rate for Payer: HFN Commercial |
$4,053.00
|
| Rate for Payer: Multiplan Commercial |
$3,524.35
|
| Rate for Payer: Preferred Network Access Commercial |
$4,053.00
|
| Rate for Payer: Quartz Beloit One Network |
$2,158.67
|
| Rate for Payer: Quartz Commercial |
$2,643.26
|
| Rate for Payer: WEA Trust Commercial |
$2,422.99
|
| Rate for Payer: WPS Commercial |
$3,262.99
|
|
|
SCREW HEADLESS COMPRESSION 4.0MM X 32MM TI 658032
|
Facility
|
OP
|
$4,236.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5729730
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,233.52 |
| Max. Negotiated Rate |
$4,053.00 |
| Rate for Payer: Aetna Commercial |
$3,964.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,788.68
|
| Rate for Payer: Aetna Managed Medicare |
$1,233.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,863.54
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,202.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,114.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,334.88
|
| Rate for Payer: Cash Price |
$1,270.80
|
| Rate for Payer: Cigna Commercial |
$4,053.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,465.35
|
| Rate for Payer: Health EOS Commercial |
$3,920.84
|
| Rate for Payer: HFN Commercial |
$4,053.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,304.08
|
| Rate for Payer: Multiplan Commercial |
$3,524.35
|
| Rate for Payer: NAPHCARE Commercial |
$2,643.26
|
| Rate for Payer: Preferred Network Access Commercial |
$4,053.00
|
| Rate for Payer: Quartz Beloit One Network |
$2,158.67
|
| Rate for Payer: Quartz Commercial |
$2,863.54
|
| Rate for Payer: Quartz Medicare Advantage |
$2,643.26
|
| Rate for Payer: The Alliance Commercial |
$2,202.72
|
| Rate for Payer: WEA Trust Commercial |
$2,422.99
|
| Rate for Payer: WPS Commercial |
$3,262.99
|
|
|
SCREW HEADLESS COMPRESSION 4.0MM X 42MM TI 658042
|
Facility
|
OP
|
$2,408.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6201048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$701.21 |
| Max. Negotiated Rate |
$2,303.97 |
| Rate for Payer: Aetna Commercial |
$2,253.89
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,153.72
|
| Rate for Payer: Aetna Managed Medicare |
$701.21
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$1,627.81
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$1,252.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$1,202.07
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,327.29
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Cigna Commercial |
$2,303.97
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$1,401.46
|
| Rate for Payer: Health EOS Commercial |
$2,228.84
|
| Rate for Payer: HFN Commercial |
$2,303.97
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$1,878.24
|
| Rate for Payer: Multiplan Commercial |
$2,003.46
|
| Rate for Payer: NAPHCARE Commercial |
$1,502.59
|
| Rate for Payer: Preferred Network Access Commercial |
$2,303.97
|
| Rate for Payer: Quartz Beloit One Network |
$1,227.12
|
| Rate for Payer: Quartz Commercial |
$1,627.81
|
| Rate for Payer: Quartz Medicare Advantage |
$1,502.59
|
| Rate for Payer: The Alliance Commercial |
$1,252.16
|
| Rate for Payer: WEA Trust Commercial |
$1,377.38
|
| Rate for Payer: WPS Commercial |
$1,854.88
|
|
|
SCREW HEADLESS COMPRESSION 4.0MM X 42MM TI 658042
|
Facility
|
IP
|
$2,408.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
6201048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,227.12 |
| Max. Negotiated Rate |
$2,303.97 |
| Rate for Payer: Aetna Commercial |
$2,253.89
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,153.72
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$1,327.29
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Cigna Commercial |
$2,303.97
|
| Rate for Payer: Health EOS Commercial |
$2,228.84
|
| Rate for Payer: HFN Commercial |
$2,303.97
|
| Rate for Payer: Multiplan Commercial |
$2,003.46
|
| Rate for Payer: Preferred Network Access Commercial |
$2,303.97
|
| Rate for Payer: Quartz Beloit One Network |
$1,227.12
|
| Rate for Payer: Quartz Commercial |
$1,502.59
|
| Rate for Payer: WEA Trust Commercial |
$1,377.38
|
| Rate for Payer: WPS Commercial |
$1,854.88
|
|
|
SCREW HEADLESS COMPRESSION 4.0MM X 44MM TI 658044
|
Facility
|
OP
|
$4,236.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5861720
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,233.52 |
| Max. Negotiated Rate |
$4,053.00 |
| Rate for Payer: Aetna Commercial |
$3,964.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,788.68
|
| Rate for Payer: Aetna Managed Medicare |
$1,233.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$2,863.54
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,202.72
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,114.61
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,334.88
|
| Rate for Payer: Cash Price |
$1,270.80
|
| Rate for Payer: Cigna Commercial |
$4,053.00
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$2,465.35
|
| Rate for Payer: Health EOS Commercial |
$3,920.84
|
| Rate for Payer: HFN Commercial |
$4,053.00
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$3,304.08
|
| Rate for Payer: Multiplan Commercial |
$3,524.35
|
| Rate for Payer: NAPHCARE Commercial |
$2,643.26
|
| Rate for Payer: Preferred Network Access Commercial |
$4,053.00
|
| Rate for Payer: Quartz Beloit One Network |
$2,158.67
|
| Rate for Payer: Quartz Commercial |
$2,863.54
|
| Rate for Payer: Quartz Medicare Advantage |
$2,643.26
|
| Rate for Payer: The Alliance Commercial |
$2,202.72
|
| Rate for Payer: WEA Trust Commercial |
$2,422.99
|
| Rate for Payer: WPS Commercial |
$3,262.99
|
|
|
SCREW HEADLESS COMPRESSION 4.0MM X 44MM TI 658044
|
Facility
|
IP
|
$4,236.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
5861720
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,158.67 |
| Max. Negotiated Rate |
$4,053.00 |
| Rate for Payer: Aetna Commercial |
$3,964.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$3,788.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$2,334.88
|
| Rate for Payer: Cash Price |
$1,270.80
|
| Rate for Payer: Cigna Commercial |
$4,053.00
|
| Rate for Payer: Health EOS Commercial |
$3,920.84
|
| Rate for Payer: HFN Commercial |
$4,053.00
|
| Rate for Payer: Multiplan Commercial |
$3,524.35
|
| Rate for Payer: Preferred Network Access Commercial |
$4,053.00
|
| Rate for Payer: Quartz Beloit One Network |
$2,158.67
|
| Rate for Payer: Quartz Commercial |
$2,643.26
|
| Rate for Payer: WEA Trust Commercial |
$2,422.99
|
| Rate for Payer: WPS Commercial |
$3,262.99
|
|
